Individual
HAROLD KEITH SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 BRADEN ST, JACKSONVILLE, AR 72076-3719
(501) 985-5900
(501) 985-6016
Mailing address
PO BOX 309, JACKSONVILLE, AR 72078-0309
(501) 985-5900
(501) 985-6016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C5449
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105321001
—
AR
Enumeration date
06/24/2005
Last updated
10/29/2008
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